title: Management of hyperextension of the metacarpophalangeal joint in association with trapeziometacarpal joint osteoarthritis.
abstract: This study investigates the management of metacarpophalangeal joint (MCP) hyperextension in patients undergoing trapeziectomy for thumb base osteoarthritis. A total of 297 thumbs with painful trapeziometacarpal osteoarthritis were assessed on pain and thumb key and tip pinch preoperatively and at 1 year. Before surgery 101 had no MCP hyperextension, 168 had hyperextension ≤ 30° and 28 had hyperextension ≥ 35°. Of these 157 hyperextension deformities ≤ 30° and eight ≥ 35° were not treated. The others were treated by temporary insertion of a Kirschner wire (n = 9), MCP fusion (n = 6), sesamoid bone tethering to the MC head (n = 5) and palmar capsulodesis using a bone anchor (n = 11). Untreated MCP hyperextension deformities < 30° did not influence the outcome of trapeziectomy. MCP hyperextension deformities ≥ 35° can be improved by capsulodesis or MCP fusion but this may not improve the clinical outcome.
authors.affiliation: Department of Trauma and Orthopaedics, Queens Medical Campus, Nottingham University Hospitals, Nottingham, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Poulter
authors.forename: T R C
authors.initials: TR
authors.lastname: Davis
mesh_terms: D001864:Bone Wires; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000601:surgery; D016916:Joint Deformities, Acquired / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010003:Osteoarthritis / Q000601:surgery*; D012716:Sesamoid Bones / Q000601:surgery; D053441:Suture Anchors; D051222:Trapezium Bone / Q000601:surgery*